Göya Cemil, Özkaçmaz Sercan, Özgökçe Mesut, Turko Ensar, Dündar İlyas, Durmaz Fatma
Yuzuncu Yıl University, Faculty of Medicine, Department of Radiology, Turkey.
Yuzuncu Yıl University, Faculty of Medicine, Department of Radiology, Turkey.
Gastroenterol Hepatol. 2022 Aug-Sep;45(7):507-514. doi: 10.1016/j.gastrohep.2021.09.004. Epub 2021 Oct 8.
In this study, we aimed to evaluate the computed tomography (CT) findings of Fasciola hepatica infestations on initial and follow-up imagings after treatment, and also to describe the role of CT during diagnosis.
In this retrospective study, patients with a diagnosis of fascioliasis by clinical and laboratory examination who underwent initial and follow-up contrast-enhanced abdominal CT scans after treatment (a single oral dose of 10mg/kg Triclabendazole) were included. The CT scans were evaluated regarding liver and spleen sizes, portal and splenic vein diameters, involved hepatic segment numbers and involvement patterns, the presence of focal perihepatic hyperdensity, gallbladder wall thickening, dilatation of the intrahepatic biliary tract, periportal-right subdiaphragmatic lymphadenopathy, hepatic subcapsular and intra-abdominal bleeding, and perihepatic/intraabdominal free fluid. Initial (pre-treatment) and post-treatment CT scans (average 25 months after the treatment) were compared with for these features.
A total of 36 patients with a mean age of 39.28±14.64 [15-83] years, were included in this study. After treatment, marked improvement in liver parenchymal involvement, biliary system findings, hepatomegaly-splenomegaly, periportal-peridiaphragmatic lymphadenopathy, and hepatic subcapsular hematoma were detected and focal perihepatic hyperdensity, free intraperitoneal fluid disappeared.
Contrast-enhanced abdominal CT can be used in the diagnosis and post-treatment follow-up of fascioliasis. Awareness of intrahepatic/extrahepatic lesions and all the complications of fascioliasis can greatly aid the diagnosis and also evaluation of the response to treatment.
在本研究中，我们旨在评估治疗前后肝片形吸虫感染的计算机断层扫描（CT）表现，并描述CT在诊断中的作用。
在这项回顾性研究中，纳入了经临床和实验室检查诊断为片形吸虫病且在治疗后（单次口服10mg/kg三氯苯达唑）接受了腹部增强CT扫描的患者，包括初始扫描和随访扫描。对CT扫描结果进行评估，内容包括肝脏和脾脏大小、门静脉和脾静脉直径、受累肝段数量和受累模式、肝周局灶性高密度影、胆囊壁增厚、肝内胆管扩张、门周-右膈下淋巴结肿大、肝包膜下和腹腔内出血以及肝周/腹腔内游离液体。将初始（治疗前）和治疗后的CT扫描（治疗后平均25个月）在这些特征方面进行比较。
本研究共纳入36例患者，平均年龄为39.28±14.64[15 - 83]岁。治疗后，发现肝实质受累、胆道系统表现、肝脾肿大、门周-膈周淋巴结肿大和肝包膜下血肿有明显改善，肝周局灶性高密度影、腹腔内游离液体消失。
腹部增强CT可用于片形吸虫病的诊断和治疗后随访。了解肝内/肝外病变以及片形吸虫病的所有并发症，对诊断及评估治疗反应有很大帮助。
